CHIP efforts have reduced local child tooth decay

From 2008 to 2010, tooth decay among Crook County k-5 students dropped from 42 percent to 29 percent

For more than four years, the Crook County Community Health Improvement Partnership (CHIP) has been fighting the battle of tooth decay and providing children in the community with something to smile about. CHIP has been addressing the oral health needs of Prineville children since 2007, and the hard work has begun to pay off. Recent oral examinations reveal a significant decline in untreated tooth decay in kindergarten through fifth grade students. In 2008, 42 percent of students examined in Crook County schools had untreated tooth decay. Last year, the number was down to 29 percent. “This work would not have been possible without the support of the Crook County School District, especially nurses Wendy Perrin and Terry Rich,” said Sharon Vail, CHIP and community education coordinator. “Even as our school district faces significant struggles, it continues to extend its resources and staff to help CHIP advance its oral health initiative.” CHIP is a volunteer organization and is sponsored and supported by Pioneer Memorial Hospital. The organization was established in 2007 with a grant from the Oregon Office of Rural Health. The grants have been initiated in 15 rural communities in Oregon. “The purpose is for the community to identify health issues that are important to the people who live here, and then get money to advise projects to address those needs,” said Vail. She said that in the beginning, groups were formed to look at some of biggest areas of need and narrow it down to four topics that were manageable. The topics involved dental services for children, prevention services for children, mental health, and healthy lifestyles. “We had grant money to create projects for those, and we brought a bunch of people in who volunteered to start CHIP and be on those committees and look further into each of the areas.” The dental committee originally had a school nurse and a member of Head Start as committee members. “They told us from the get-go that they are seeing young children with what they call “blown-out mouths” — which is just a mouthful of decay and not getting any dental care,“ commented Vail. She said the problem was too big to just fix teeth, and would require a prevention approach to the problem. “That’s when we started looking at fluoride varnish, because fluoride is an evidence-based prevention of tooth decay. We don’t have fluoridated water in Crook County. As a state, Oregon doesn’t have a lot of fluoridation.” Vail said that varnish is a simple, safe, easy-to-apply method. CHIP soon received more grant money to provide free fluoride varnish to any child in grades k-5 who wanted it and was not already getting it from their own dentist. Bob Gomes, Pioneer Memorial Hospital CEO, said that hospitals are not traditionally in the dental business. He said that when they did the CHIP program and they looked at the dental health in the community, it grabbed their attention at the hospital. “What really came to light was when I asked after I got here a year ago for our top 10 diagnoses the previous year,” explained Gomes. “The number one diagnosis in 2009 in our emergency room was tooth disorder or tooth pain. It wasn’t huge numbers, but it was the one that had the most visits for.” Gomes said that most of these visits involved adults, and they don’t see a lot of school-age children in the emergency room. “It’s two different populations, but what we expect to happen is that over time that should decrease.” Gomes said that recently, the CHIP program has partnered with Advantage Dental — and through the partnership of these two organizations and the hospital, they are able to address tooth decay in school-age children at a higher level. In addition to these partnerships, CHIP has been able to arrange for the Dental Foundation of Oregon’s Tooth Taxi to visit Prineville three times in the past year, which has provided $80,000 worth of free dental care to 70 children who wouldn’t have been able to see a dentist on their own. “We still have work to do because there are pockets of high decay rate, but we are excited about the progress we’re making,” Vail said. “This is a significant drop in just two years. It reinforces our belief that prevention is the key to tooth decay.”